This paper evaluates whether oral cephalosporins should be preferred over other oral antibiotics (e.g., fluoroquinolones, trimethoprim-sulfamethoxazole) for empiric outpatient treatment of acute pyelonephritis.
The authors argue that cephalosporins offer a favorable balance of efficacy, tolerability, and resistance profiles, supporting their use as first-line empiric oral therapy for outpatient acute pyelonephritis.
The paper appears to be a position/opinion piece or narrative argument rather than a primary clinical trial, limiting the strength of direct evidence. Specific patient subgroup data (e.g., pregnancy, immunocompromised) and regional resistance patterns may not be fully addressed.
Consider oral cephalosporins as the default empiric choice for outpatient acute pyelonephritis, particularly given rising fluoroquinolone resistance and TMP-SMX resistance variability. Reserve fluoroquinolones and TMP-SMX for cases with known susceptibility data.
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